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    Functional Reconstruction of Large Lower Lip Defects with Adjustable Suture Assisted Palmaris Longus Tendon in Free Flaps
    (Düzce Üniversitesi, 2013) Aytekin, Ahmet Hamdi; Elmas, Ömer; Erbatur, Serkan; Geyik, Yılmaz; Fırat, Cemal
    Purpose: In this study, our objective is to present the modified method which ensures thereconstruction of the wide defects of the lower lip via the adjustable palmaris longus tendonof the radial forearm flap.Methods: 65 year old male patient applied with complaints of a 5x4 cm well differentiatedsquamous cell carcinoma on the lower lip region. One cm safety border was kept and the lesionwas excised. The free radial forearm flap was transferred to the defect and anastomosed toright facial artery and vein. The 20 cm palmaris longus tendon was passed through the flapclose to the localization planned as the upper border of the lower lip and tendon stretched toboth malar regions and extended to temporal region with 2/0 propilen suture.Results: Tips of the suture were left on the subcutaneous level for further adjustment ifnecessary. Palmaris longus tendon prevents lower lip prolapse. Follow-up period was 6months. A lymphedema was developed at early period (first 3 months) that was regressed until6 months progressively. The oral competence was acceptable with speech and feedingfunctions.Conclusion: This method is easily applicable to adjust lip tension or tonus during the 3-4 dayinterval required for the palmaris longus tendon to affix to the malar region. Mean time forfixation of the tendon was 7 days